Multislice CT Staging Value Of Cervical Cancer

Objective1. To investigate the value of multislice CT in cervical cancer staging.2. To investigate MDCT in judging the value of cervical lymph node metastasis.Materials and MethodsGeneral information:160cases diagnosed with cervical cancer clinically wereselected in this study. All these cases had the confirmed pathology after surgery，and theyall underwent CT staging. Their FIGO staging，surgical pathological staging and lymphnodes metastasis were recorded. Their average age is45.9years (the ages extent from24to76). And most of them had the same symptoms, including contact bleeding, increasedvaginal discharge and/or vaginal bleeding after menopause.Methods: The methods of CT scanning included plain scanning and enhancedscanning with PHILIPS scan CTs (128or64rows). The scanning conditions were:120KV,200mAs,5mm slice thickness,1.5mm pitch. The obtained data was thinned by standardalgorithm with0.625mm slice thickness,0.312mm layer and0.67mm slice thickness,0.335mm layer. Then the reconstructed images were transmitted to workstation, where theimages were MPR reconstructed sagittall y and coronally by double window width andwindow level（40,220;40,400). The usage amont of contrast agent is1.5ml/kg,2.5ml/s bythe high-pressure injection of the cubital vein. Patients should absolute diet4h beforescanning and do the breathholding training. The scanning range is from the beginning ofthe third lumbar vertebra to the pubic symphysis.The comparative analysis was done between CT staging, FIGO staging and surgical staging of the160cases. And the evaluation of lymph node metastasis in patients withcervical cancer was done.ResultsThe accuracy of CT staging of cervical cancer was80.00%(128/160), judged too low6.25%(10/160), judged too high13.75%(22/160). The FIGO staging overall accuracy ratewas61.25%(98/160), judged too low22.50%(36/160), judged too high16.25%(26/160).38cases in160(23.75%) were pathologically proved lymph nodes metastasis with52regional lymph nodes metastasis.40cases in160(25.00%) were judged lymph nodesmetastasis by CT staging, and54regional lymph nodes metastasis. So, sensitivity Se=71.05%, specificity degree Sp=89.34%, Youden index the YI=0.60, the rate ofmisdiagnosis β=28.95%, the rate of misdiagnosis α=11.66%, positive predictivevalue+PV=67.50%, negative predictive value-PV=90.83%.ConclusionCT staging accuracy was significantly higher than FIGO staging. The pre-treatmentCT scanning has been used as one of the routine examination of cervical cancer, and it cando some extent making up for the lack of FIGO staging. It has the higher accuracy oflymph node metastasis in uterine cervix cancer in CT staging. It can provide the basis forclinical treatment options by aggregate analysis of the size, number and density of lymphnode.